The present invention relates to a method and apparatus for accessing the pericardial space. More particularly, the present invention is directed to a method and apparatus for accessing the pericardial space via the right atrial appendage.
The pericardium is a membrane that surrounds the heart and isolates the heart from the remainder of the body. The small space between the heart and the pericardium is the pericardial space, which is filled with a fluid. The pericardial space has become an optimal location to administer cardiac treatments because the pericardial fluid is in constant contact with the heart muscle. However, the pericardial space is a confined area that is difficult to access without damaging the underlying heart tissue.
The right atrial appendage has become an ideal site for accessing the pericardial space because it is a thin-walled lobe that can easily be penetrated with a catheter. Also, the funnel-shape of the right atrial appendage acts as a guide for placing a catheter next to the apex of the appendage, which is adjacent to the pericardial space However, the apex of the right atrial appendage is in close proximity to the pericardial sack and the right atrium wall permitting little room for error when performing work on the right atrial appendage wall at the apex. This small amount of space creates a risk of puncturing the right atrium wall or pericardial sack with the catheter. In addition, there is a risk of mixing pericardial fluid from the pericardial space with blood in the right atrial appendage when the apex is pierced.
Therefore, there is a need in the art for a method and apparatus for accessing the pericardial space that reduces the risk of puncturing tissue not intended to be punctured and reduces the risk of mixing fluids.